Meds vs TMS: How does TMS work and how is it different from antidepressant medications?

Our goal here at TMS of Wilmington is to provide the most comprehensive and highest standard of care for patients with depression, helping to bring their minds and bodies back to a balance.

Major depression can cause changes within a variety of systems, such as

  • Genetic
  • Biochemical
  • Electrophysiological
  • Anatomical – functional connectivity in various brain networks. Functional connectivity refers to the ability for multiple regions of the brain to fire at the same time.

Since there are changes across all of these systems, modern research regarding details of changes in these systems is helping to develop multi-targeted therapies that work better than the conventional antidepressant medication treatment. Antidepressants serve to address depression from a biochemical perspective as compared to TMS, which is addressing depression from an electrophysiological perspective.

In the TMS procedure, a magnetic field is projected into a specific area in the frontal lobe of the brain,i.e left DLPFC, left Dorsolateral prefrontal Cortex that is responsible for regulating mood. The left DLPFC also connects with other deeper areas of the brainĀ  as part of a Large Scale Network. In particular, TMS targets the neural circuit of the subgenual anterior cingulate cortex, default mode network, central executive network, and the dorsolateral prefrontal cortex. The magnetic field repetitively sent into the brain increases the activity in these neural network that fail to function properly in patients with depression and enhances the inter-connectivity ,while you are taking the medication. Using antidepressant medication can have a variety of side effects, unlike TMS where side effects are relatively limited.

Another modality of treating treatment-resistant depression is using Electroconvulsive therapy (ECT). ECT also addresses depression from an electrophysiological perspective like TMS. However, it has some very significant downsides compared to TMS. It is an invasive process only carried out in a hospital setting as it requires the patient to be under anesthesia. Additionally, it can cause memory loss and affect normal functioning while you are going through the treatment process. The patient will need support from someone to drive them after every treatment.

On the other hand, TMS is a noninvasive process that does not affect normal functioning. The patient is fully awake and can converse even during the treatment and can even drive and go back to work directly afterward. The only side effect with TMS can be scalp discomfort only while doing the treatment.

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